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Natural History of Intraocular Pressure in the Early Manifest Glaucoma Trial A 6-Year Follow-up

Hyman, Leslie; Heijl, Anders LU ; Leske, M. Cristina; Bengtsson, Boel LU and Yang, Zhongming (2010) In Archives of Ophthalmology 128(5). p.601-607
Abstract
Objectives: To characterize intraocular pressure (IOP) changes during 6 years of follow-up among patients with early, newly diagnosed glaucoma randomized to no initial treatment in the Early Manifest Glaucoma Trial (control group) and to evaluate factors associated with IOP changes in this group. Methods: Early Manifest Glaucoma Trial control patients, aged 50 to 80 years at baseline, were followed up for 6 years or to the time of progression, when treatment could be initiated. After baseline, patients were followed up every 3 months with comprehensive ophthalmologic examinations, including Goldmann applanation tonometry. Change in IOP over 6 years was assessed by linear regression analyses. Results: At baseline, the median IOP of this... (More)
Objectives: To characterize intraocular pressure (IOP) changes during 6 years of follow-up among patients with early, newly diagnosed glaucoma randomized to no initial treatment in the Early Manifest Glaucoma Trial (control group) and to evaluate factors associated with IOP changes in this group. Methods: Early Manifest Glaucoma Trial control patients, aged 50 to 80 years at baseline, were followed up for 6 years or to the time of progression, when treatment could be initiated. After baseline, patients were followed up every 3 months with comprehensive ophthalmologic examinations, including Goldmann applanation tonometry. Change in IOP over 6 years was assessed by linear regression analyses. Results: At baseline, the median IOP of this cohort (N = 118) was 20.8 mm Hg and was higher for the 15 patients with exfoliation glaucoma (24.0 mm Hg vs 20.0 mm Hg for others; P = .005). In patients without exfoliation glaucoma, IOP remained stable during follow-up (median IOP change of -0.01 mm Hg/y; interquartile range, 0.85 mm Hg/y). In comparison, patients with exfoliation glaucoma showed a significantly larger median change of 0.96 mm Hg/y (interquartile range, 3.11 mm Hg/y) (P = .004). In the overall cohort, the only factor related to IOP change was exfoliation glaucoma (P < .001). Among patients without exfoliation glaucoma, no factors were associated with IOP change. Conclusions: In patients with early glaucoma, IOP remained stable without treatment during a 6-year period, regardless of baseline IOP, except for patients with exfoliation glaucoma, where IOP increased by almost 1 mm Hg annually. No factors, aside from exfoliation glaucoma, were related to longitudinal changes in IOP. These new natural history data may be useful in guiding management decisions for glaucoma treatment, particularly in patients with early disease or with exfoliation glaucoma. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Archives of Ophthalmology
volume
128
issue
5
pages
601 - 607
publisher
American Medical Association
external identifiers
  • wos:000277466800011
  • scopus:77952186641
ISSN
0003-9950
language
English
LU publication?
yes
id
bfc49eb7-35e0-4c2f-827f-6a53484f402c (old id 1618909)
alternative location
http://archopht.ama-assn.org/cgi/content/abstract/128/5/601
date added to LUP
2010-06-22 09:04:22
date last changed
2018-05-29 11:23:33
@article{bfc49eb7-35e0-4c2f-827f-6a53484f402c,
  abstract     = {Objectives: To characterize intraocular pressure (IOP) changes during 6 years of follow-up among patients with early, newly diagnosed glaucoma randomized to no initial treatment in the Early Manifest Glaucoma Trial (control group) and to evaluate factors associated with IOP changes in this group. Methods: Early Manifest Glaucoma Trial control patients, aged 50 to 80 years at baseline, were followed up for 6 years or to the time of progression, when treatment could be initiated. After baseline, patients were followed up every 3 months with comprehensive ophthalmologic examinations, including Goldmann applanation tonometry. Change in IOP over 6 years was assessed by linear regression analyses. Results: At baseline, the median IOP of this cohort (N = 118) was 20.8 mm Hg and was higher for the 15 patients with exfoliation glaucoma (24.0 mm Hg vs 20.0 mm Hg for others; P = .005). In patients without exfoliation glaucoma, IOP remained stable during follow-up (median IOP change of -0.01 mm Hg/y; interquartile range, 0.85 mm Hg/y). In comparison, patients with exfoliation glaucoma showed a significantly larger median change of 0.96 mm Hg/y (interquartile range, 3.11 mm Hg/y) (P = .004). In the overall cohort, the only factor related to IOP change was exfoliation glaucoma (P &lt; .001). Among patients without exfoliation glaucoma, no factors were associated with IOP change. Conclusions: In patients with early glaucoma, IOP remained stable without treatment during a 6-year period, regardless of baseline IOP, except for patients with exfoliation glaucoma, where IOP increased by almost 1 mm Hg annually. No factors, aside from exfoliation glaucoma, were related to longitudinal changes in IOP. These new natural history data may be useful in guiding management decisions for glaucoma treatment, particularly in patients with early disease or with exfoliation glaucoma.},
  author       = {Hyman, Leslie and Heijl, Anders and Leske, M. Cristina and Bengtsson, Boel and Yang, Zhongming},
  issn         = {0003-9950},
  language     = {eng},
  number       = {5},
  pages        = {601--607},
  publisher    = {American Medical Association},
  series       = {Archives of Ophthalmology},
  title        = {Natural History of Intraocular Pressure in the Early Manifest Glaucoma Trial A 6-Year Follow-up},
  volume       = {128},
  year         = {2010},
}